Diagnosing Intercostal Neuralgia

What is intercostal neuralgia?

Intercostal neuralgia is a type of neuropathic (nerve) pain. It involves the nerves that arise from the spinal cord and lie beneath the ribs. These nerves are connected to the muscles of the rib cage, skin and chest cavity.

How is intercostal neuralgia diagnosed?

Intercostal neuralgia is a diagnosis of exclusion. No specific test currently exists for the condition; an intercostal neuralgia diagnosis is based on a physical exam as well as the elimination of the possibility of other medical conditions.

As the symptoms of intercostal neuralgia mimic many other conditions, including conditions involving the heart and lungs, a physician will likely exclude the possibility of any other causes of pain first. If another cause is not found, intercostal neuralgia may be suspected.

• Physical exam
  During a physical exam, the individual may be asked to take a deep breath. A health care provider may then press on the areas between the ribs at the location of the intercostal nerves. The presence of pain with these actions may lead to a diagnosis of intercostal neuralgia.
• Medical history and tests
  Physicians may look at the individual’s medical history for a recent illness, such as shingles, or a recent surgery which could have caused intercostal neuralgia. They may also order X-rays, an ultrasound, a CT or an MRI scan to look for signs of injury that could be affecting the intercostal nerves.